Individual provider Active NPI

Payam Hooshmand, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1982184024
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103091 Issued in CA
Practice address
2195 Station Village Way Apt 1215
San Diego, CA 92108-6529
Phone
(520) 300-0645
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103091 CA Primary

Addresses

Primary practice location

2195 Station Village Way Apt 1215
San Diego, CA 92108-6529

Mailing address

2195 Station Village Way Apt 1215
San Diego, CA 92108-6529
Phone (520) 300-0645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103091CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Payam Hooshmand,DMD, Inc. Dentist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1982184024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 STATION VILLAGE WAY APT 1215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086529",
            "telephone_number": "520-300-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 STATION VILLAGE WAY APT 1215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086529",
            "telephone_number": "520-300-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOSHMAND",
        "first_name": "PAYAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.